Healthcare Provider Details

I. General information

NPI: 1043134828
Provider Name (Legal Business Name): AMANA MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 TOWER AVE STE 333
SUPERIOR WI
54880-2553
US

IV. Provider business mailing address

1507 TOWER AVE STE 333
SUPERIOR WI
54880-2553
US

V. Phone/Fax

Practice location:
  • Phone: 715-338-2315
  • Fax: 715-945-5006
Mailing address:
  • Phone: 715-338-2315
  • Fax: 715-945-5006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ALI IBRAHIM
Title or Position: MANAGER
Credential:
Phone: 715-338-2315